Disc Herniation Emergency Symptoms

Disc Herniation Emergency Symptoms

Although back pain is common, it can also be caused by sudden numbness, difficulty urinating, weakness in the legs, or a sudden appearance in the genital region, it can be a serious medical emergency. Cauda Equina syndrome is usually caused by a disc herniation at the lower back, which compresses the nerve roots near the end of your spinal cord. These nerves transmit messages from the bladder, bowel and legs. They can become permanently damaged if they are left squeezed too long. Urgent surgery may be necessary to alleviate the pressure and prevent any permanent damage.

Herniated Disc Symptoms

A herniated disc can cause back pain in the lower back. This area is also known as the lumbar spine, lumbar region or lumbar region. These symptoms may occur if you have a herniated disc in this area.

  • Lower back pain that is burning, sharp, or achy
  • Pain radiating down one leg from the buttocks or lower back
  • One leg weakness, tingling, or numbness

A cervical spine or neck slipped disc can cause symptoms such as:

  • Headache, particularly in the back of your head
  • A burning sensation in the neck or shoulder that can cause pain in one arm
  • One arm weakness, tingling, or numbness
  • Because they place more pressure on the nerve, sneezing, coughing and sitting down can worsen symptoms.

What is cauda-equina syndrome?

Cauda Equina Syndrome is a rare but serious condition that can have severe consequences if it is not treated quickly. This is usually caused by a large disc herniation at the lower back, which compresses the nerve roots near the end of your spinal cord (Fig. 1). These nerve roots look like the tail of horses and are wrapped together. This is how they got their names. Cauda equina means “horse’s tail” in Latin.

Cauda Equina, unlike most back problems, is not long-standing or chronic. It is an acute event like a stroke, heart attack, or other medical conditions. It usually develops quickly, in as little as six to ten hours. A medical emergency is when you have classic symptoms like back pain and suddenly onset of numbness or urinary retention. It is important to quickly relieve compression so that one can return to a normal lifestyle or live with paralysis and incontinence.

Cauda equina may develop slowly in those with chronic back problems. Cauda equina syndrome, which affects the nerves controlling the bladder, can cause symptoms similar to those associated with bladder or prostate problems.

What are the signs?

Cauda Equina compression can cause problems in the bladder, bowel, and sexual function. Many people experience severe pain in their low backs and buttocks, as well as numbness or tingling in the “saddle” (rectal and genital area and inner thighs). The pain may radiate down the back of your thigh to the foot and calf (sciatica). A person might feel paralysis or weakness in their leg or foot when trying to get up from a chair. Extreme leg weakness or loss of bladder function or bladder function can be signs of an emergency. Seek medical attention immediately.

What are the causes of this?

Cauda Equina Syndrome can be caused by a large-sized ruptured disc. A herniation is when the gel-like center of a spinal disc can burst or rupture through the disc wall. This could compress nerves. The L4-5 and L5-S1 discs of the lumbar spine are the most common sites for disc herniation. Sports injuries, falls, and car accidents can cause the spine to be fractured or tear muscles, causing nerve damage. Another cause is a narrowing or obstruction of the spinal canal (stenosis), tumor, infection, or hemorrhage.

What is the process of diagnosing a condition?

A thorough medical exam will confirm or exclude a suspicion of cauda horseman. A medical history and a physical exam are part of the evaluation. An obvious finding is loss of sensation in anal area. An MRI scan will be performed on a patient with severe leg weakness, numbness or loss of bladder function or bladder function. This will reveal how much the herniation has compressed the spinal nerves. A CT scan or myelogram may also be ordered by the doctor.

What are the available treatments?

Surgery is often necessary for patients suffering from acute cauda-equina syndrome. The purpose of surgery is to relieve pressure from the spinal nerves and restore sensation and muscle function to bladder, bowel and legs. One of the following procedures may be performed depending on the cause:

A discectomy is performed to remove the part of the disc that has been causing nerve compression. A small incision is made in the middle of your back by the surgeon. To expose the bony vertebra, the spinal muscles are removed. To expose the nerve root, and disc, a window of bone is cut. It is carefully removing the portion of the ruptured disc that compresses the spinal nerves.

Spinal decompression is used to treat stenosis. It removes bone spurs and ligaments that compress the nerves. The surgeon makes a small incision in the back. The surgeon will remove the spine canal’s roof bone. To make more space for nerves, the surgeon will remove soft tissue and bone spurs. Other lesions, such as tumors, can also be removed.

Clinical trials

Clinical trials are research studies that test new treatments, such as diagnostics and procedures, on people to determine if they work and if they are safe. To improve medical care, research is ongoing. You can find information about current clinical trials on the Internet, including details such as eligibility, protocol and locations. The National Institutes of Health, private industry and pharmaceutical companies can sponsor studies.

Recovery and prevention

Cauda Equina Syndrome can cause some bladder and bowel functions to be automatic. However, those that are under voluntary control might become impaired. This could mean that you may not be able to know when or how to move your bowels.

The severity of the symptoms and the length of time the nerves have been compressed before the surgery can determine the likelihood of recovery from cauda-equina. People with urinary retention have a lower chance of complete recovery [1,2].

  • 90% of those with numbness or tingling in their genital area (incomplete CE) regained normal bladder and bowel function.
  • 20 percent of those with bladder retention (complete CES) may experience permanent incontinence or loss of sensation in their pelvic area.
  • It may take several months for residual problems to be resolved after surgery. Rehabilitative methods, such as bladder retraining, may be necessary.

Permanent injuries can cause changes in the daily life of those who are affected. Physical therapists can help them learn important self-care skills, including self-catheterization, stress management, and relaxation techniques. A psychiatrist can also be helpful (for those suffering from depression), as well as a support group, a social worker and a sextherapist.

Paralysis of the legs can occur in rare cases.

5 Back Pain Emergencies

Worldwide, lower back pain is a major cause of disability. According to a study, 75-85% of Americans will experience back pain at some point in their lives. The most common cause of back pain is a problem in the lower back. This includes the muscles, nerves, and spine.

Back pain can be either acute or temporary and last from a few days to several weeks. Some people develop chronic back pain that can last for up to three months. There are back pain emergencies, which require immediate attention and, at times, surgery. These are some symptoms:

Common Signs and Symptoms of Back Pain Emergencies

  • Severe back pain
  • Lethargy in the limbs
  • Inadequate bladder and bowel control
  • Sharp pain in the arms and legs
  • Different parts of the body may feel numb or tingling.

Different types of back pain emergencies

Any of the symptoms mentioned above could indicate a back problem.

Spinal Fracture

Accidents or high-energy trauma can cause spinal fractures. It is characterized by severe back pain that worsens with movement. The fracture may cause nerve damage and/or spinal cord dysfunction.

Cauda Equina Syndrome (CES)

Cauda Equina, Latin for “horse’s tail”, is the bundle of spinal neuros at the end the spinal cord. CES is caused by spinal nerve compression, which can also affect the sensory and motor functions of the bladder as well as the lower extremities. CES can lead to permanent paralysis. Symptoms include severe low back pain, motor weakness and pain in one or two legs.

Severe Herniated disc

The shock absorbers are round discs that cushion the bones of the spine. A herniated disc is a disc that has become swollen from excessive strain or sudden injury. A herniated disc is considered a medical emergency in cases of severe pain and discomfort. It can cause lower back pain, severe pain in the legs or arms, loss of bladder control, and numbness, weakness, or tingling sensations in the feet and/or legs.

Metastatic Spinal Cord Compression – MSCC

Metastatic spinal cord compression (MSCC), a common complication of cancer, is often a serious condition that requires immediate care. This happens when cancer cells grow in the spine or press on the spinal cord. It can cause severe neck or back pain, which may be worsened if you cough, sneeze or go to the toilet. Other symptoms include severe back or leg pain, difficulty controlling your bladder or bowel, chest or abdomen pain, and numbness/tingling in various parts of the body. MSCC can lead to paralysis if left untreated.

Vertebral Osteomyelitis

Vertebral Osteomyelitis, the most common type of spinal infection, can be caused either by trauma to the spine or bacterial or fungal infections that have spread from the blood. An inflammatory reaction can cause damage to the cortex, bone and other structures. This condition can cause severe back pain as well as fever, chills and weight loss.

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Kevin Pauza, M.D.

SPECIALTY

  • Disc Biologics
  • Interventional Spine

EDUCATION & DEGREES

  • Fellowship: Interventional Spine, University of Pennsylvania
  • Residency: PM&R, University of Pennsylvania
  • Internship: Surgery & Medicine, Columbia University College of Physicians and Surgeons
  • Medical Doctorate: Pennsylvania State University College of Medicine
  • Bachelor of Arts: Biology, Lehigh University
  • Bachelor of Arts: Psychology, Lehigh University

CERTIFICATIONS & LICENSES

  • Texas State Medical and Surgical License
  • New York State Medical and Surgical License
  • Florida State Medical and Surgical License

HONORS

  • Lehigh University Four-year Academic Scholarship
  • Magna Cum Laude, Lehigh University
  • Lehigh University President’s Award
  • Lehigh University Tower Society
  • Distinguished Alumnus, Penn State University (selected from 500,000 Penn State alumni)
  • North American Spine Society, Outstanding Paper of the Year, 2003
  • President-Elect, International Spine Intervention Society
  • Founding Partner, Texas Spine and Joint Hospital
  • Commencement Speaker: Penn State University College of Medicine
  • Advisory Board, AMA
    Keynote Speaker, Harvard Pain Center Commencement
  • Founding Chairman, Standards Committee, International Spine Intervention Society
  • Chairman, Spine Committee, Amercian Academy of Physical Medicine & Rehabilitation
  • Appointed Spine Advisor, Japanese Prime Minister
  • Appointed Spine Advisor, Allied Royal Families

EXPERIENCE

  • Founding Partner & Principal, Texas Spine & Joint Hospital

Haley Burke, M.D. - Colorado Rehabilitation & Occupational Medicine

Dr. Burke is board-certified in both Interventional Pain Management and Neurology and has completed an accredited Pain Fellowship with the Department of Anesthesiology at MD Anderson Cancer Center, one of the nation’s most prestigious hospitals. Dr. Burke completed her residency in Neurology at the University of Colorado, where she received the department’s ‘Excellence in Teaching’ award during her year as Chief Resident. Her Doctor of Medicine degree was completed at the University of Texas Health Science Center, where she was elected to the ‘Gold Humanism Honor Society.’

Haley Burke, M.D. - Colorado Rehabilitation & Occupational Medicine

Dr. Burke is board-certified in both Interventional Pain Management and Neurology and has completed an accredited Pain Fellowship with the Department of Anesthesiology at MD Anderson Cancer Center, one of the nation’s most prestigious hospitals. Dr. Burke completed her residency in Neurology at the University of Colorado, where she received the department’s ‘Excellence in Teaching’ award during her year as Chief Resident. Her Doctor of Medicine degree was completed at the University of Texas Health Science Center, where she was elected to the ‘Gold Humanism Honor Society.’

Matthias H. Wiederholz, M.D. - Performance Pain and Sports Medicine

Founding Partner, Triple Board Certified – Physical Medicine & Rehabilitation; Sports Medicine; Anti-Aging, Regenerative & Functional Medicine

Dr. Matthias H. Wiederholz is cofounder of Performance Spine & Sports Medicine, LLC. He is a fellowship-trained interventional pain physician whose clinical interests include: Interventional Pain Management, Sports Medicine, Musculoskeletal Medicine, Minimally-Invasive Spine Surgery, Non-Surgical Orthopedics, and Anti-Aging / Functional Medicine.

He received his specialty training in Physical Medicine and Rehabilitation at Baylor College of Medicine in Houston, Texas where he served as chief resident. He completed fellowship training in Interventional Pain Management in Marietta, Georgia. He is board-certified in Physical Medicine & Rehabilitation and Sports Medicine. He also received advanced fellowship training through the American Academy of Anti-Aging Medicine and is board-certified in Anti-Aging, Regenerative & Functional Medicine.

Dr. Wiederholz performs a myriad of interventional pain procedures including, but not limited to the following: epidural steroid injections, facet joint injections, radiofrequency ablation, sacroiliac joint injections, discography, percutaneous disc decompression, epidural lysis of adhesions spinal cord stimulator implants, and minimally-invasive discectomies. Endoscopic spine surgery is a very unique and valuable tool in his armamentarium and makes Dr. Wiederholz one of the most specialized physicians in the field of Pain Medicine.

Dr. Wiederholz uses musculoskeletal ultrasound in the diagnosis of musculoskeletal injuries. He incorporates ultrasound for precise injection therapy including cortisone injections, prolotherapy, and PRP (platelet rich plasma). This technology is also utilized to perform the Tenex procedure, a percutaneous procedure for treating chronic tendon pain (tennis elbow, rotator cuff, plantar fasciitis, etc).

Dr. Wiederholz is the fellowship director for the sports and spine fellowship at Performance Spine & Sports Medicine. Dr. Wiederholz holds an affiliation with Capital Health System and JFK Johnson Rehabilitation Institute.

Being advanced fellowship trained in Anti-Aging, Regenerative & Functional Medicine means that Dr. Wiederholz has the most advanced training in Anti-Aging Medicine available. He is a leading expert in Bio-Identical Hormone Restoration and helps patients achieve wellness through nutrition, lifestyle, and hormone therapies.

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Yasuyuki Nonaka, M.D. - Nonaka Lumbago Clinic

Kevin Pauza, M.D. - Turtle Creek Surgery Center

Prior to attending Penn State University, Dr. Pauza earned his undergraduate degree from Lehigh University, and furthered his training with a Surgical and Medical Internship at Columbia University College of Physicians and Surgeons. He continued his specialty training at the University of Pennsylvania, followed by an Interventional Spine Fellowship. In addition to his research, philanthropic, and clinical endeavors, Dr. Pauza remains a motivated educator. He established a Spine Fellowship program and continues training physicians from around the world. He heads international committees responsible for establishing standards and educating surgical and non-surgical physicians.

After helping hundreds of patients who failed to experience relief after spine surgery, it became evident to Dr. Pauza that current methods needed to change. This motivated him to seek better ways to help patients, by thinking outside the box.

Dr. Pauza is the first physician in history to pursue FDA approval for using biologics to treat the spine. Millions of patients will benefit from his development of minimally invasive treatments for degenerative disc disease and other more common and serious disorders of the spine.

SPECIALTY

  • Disc Biologics
  • Interventional Spine

EDUCATION & DEGREES

  • Fellowship: Interventional Spine, University of Pennsylvania
  • Residency: PM&R, University of Pennsylvania
  • Internship: Surgery & Medicine, Columbia University College of Physicians and Surgeons
  • Medical Doctorate: Pennsylvania State University College of Medicine
  • Bachelor of Arts: Biology, Lehigh University
  • Bachelor of Arts: Psychology, Lehigh University

CERTIFICATIONS & LICENSES

  • Texas State Medical and Surgical License
  • New York State Medical and Surgical License
  • Florida State Medical and Surgical License

HONORS

  • Lehigh University Four-year Academic Scholarship
  • Magna Cum Laude, Lehigh University
  • Lehigh University President’s Award
  • Lehigh University Tower Society
  • Distinguished Alumnus, Penn State University (selected from 500,000 Penn State alumni)
  • North American Spine Society, Outstanding Paper of the Year, 2003
  • President-Elect, International Spine Intervention Society
  • Founding Partner, Texas Spine and Joint Hospital
  • Commencement Speaker: Penn State University College of Medicine
  • Advisory Board, AMA
    Keynote Speaker, Harvard Pain Center Commencement
  • Founding Chairman, Standards Committee, International Spine Intervention Society
  • Chairman, Spine Committee, Amercian Academy of Physical Medicine & Rehabilitation
  • Appointed Spine Advisor, Japanese Prime Minister
  • Appointed Spine Advisor, Allied Royal Families

EXPERIENCE

  • Founding Partner & Principal, Texas Spine & Joint Hospital

Brandon Tolman, D.O. - Nashville Spine Institute

Boris Terebuh, M.D. - Regenerative Spine & Joint Center

Boris Terebuh, MD specializes in providing personalized nonsurgical solutions for spine problems that interfere with the function patients desire and the independence they deserve. Dr. Terebuh completed his Physical Medicine & Rehabilitation residency training at The Ohio State University in 1997 and has been in solo practice in Ohio since 2001 because he is committed to providing accessible, individualized and attentive care to his patients. His regenerative approach to solving spine problems enhances the body’s natural ability to heal itself. His guiding principle is integrity – doing what is right for patients in a conscientious manner with the motivation of helping them become fully functional, independent and satisfied. Dr. Terebuh is a very unique Medical Doctor because he has earned seven Board Certifications in the field of musculoskeletal medicine and nonsurgical spine care. Boris Terebuh, MD is delighted to be a Discseel® provider because this revolutionary new technology aligns perfectly with his preferred regenerative treatment approach and patient care philosophy. Dr. Terebuh is also grateful to Discseel® developer, Kevin Pauza, MD, for all the years of diligent and meticulous research to create this innovative, paradigm-shifting intervention, which will certainly spare countless individuals the prospect of avoidable spine surgical procedures.

Thierry Bonnabesse, M.D. - Champlain Spine and Pain Management

Gregory Lutz, M.D. - Regenerative Sportscare Institute

Dr. Gregory Lutz is the Founder and Medical Director of the Regenerative SportsCare Institute (RSI). In addition, he currently serves as Physiatrist-In-Chief Emeritus at Hospital for Special Surgery (HSS) and a Professor of Clinical Rehabilitation Medicine at Weill Medical College of Cornell University. Dr. Lutz is one of the world’s leading experts in the field of regenerative interventional orthopedic medicine, appearing annually on Castle Connolly’s and New York Magazine’s “Top Doctors” lists.

Janet Pearl, M.D. - The Boston Stem Cell Center

Dr. Janet Pearl has been in practice since 1999 and is the Medical Director of The Boston Stem Cell Center. She is also the Medical Director of  Complete Spine and Pain Care  an interventional integrated Pain Management practice, both located in Framingham, Massachusetts. Dr. Pearl is Triple Board Certified in Regenerative Medicine, Pain Medicine and Anesthesiology and has over 20 years experience in doing these procedures.

Previously, Dr. Pearl was the Co-Director of the Pain Management Center at St. Elizabeth’s Medical Center, where she was also the Director of the Pain Management Fellowship program.

After graduating from Harvard College with an A.B. in Applied Mathematics with Economics, Dr. Pearl received a M.Sc. in Health Planning and Financing at the London School of Hygiene and Tropical Medicine. She then received her M.D. from the Columbia College of Physicians and Surgeons, where she represented the Medical School as a senator in the Columbia University Senate.

Watch Dr Pearl give an introduction to The Boston Stem Cell Center

Dr. Pearl completed her internship in Internal Medicine at New England Deaconess Hospital, her residency in Anesthesiology at the Massachusetts General Hospital, and her fellowship in Pain Management at the Brigham and Women’s Hospital. Dr. Pearl was the first resident ever to serve on the Accreditation Council for Graduate Medical Education (ACGME)’s Residency Review Committee for Anesthesiology. She is a Joseph Collins Scholar and a Rotary Scholar and was awarded the AMA/Glaxo Welcome and AMA/Burroughs Welcome Resident Leadership Awards.

From 2004 to 2010, Dr. Pearl served on the University of Massachusetts Board of Trustees. While there she chaired the Committee on Science, Technology and Research, was a member of the Committee on Academic and Student Affairs and the Governance Committee and also served as Vice Chair of the Advancement Committee, and as a member of the Committee on Athletics.

Dr. Pearl is Board Certified in Regenerative Medicine, Pain Medicine and Anesthesiology with the American Board of Regenerative Medicine and the American Board of Anesthesiologists.

Memberships:

  • The American Pain Society;
  • The Massachusetts Medical Society;
  • The Massachusetts Society of Anesthesiologists;
  • The Massachusetts Society of Interventional Pain Physicians;
  • The American Society of Anesthesiologists;
  • The American Society of International Pain Physicians;
  • The American Institute of Ultrasound in Medicine; and,
  • The American Board of Regenerative Medicine.

PUBLIC SERVICE:

  • Member, Massachusetts Department of Industrial Accidents, Health Care Services Board 
  • Member of the Association of Harvard College Class Secretaries and Treasurers
  • Past Member of the Board of Directors of the Harvard Alumni Association
  • Former Member of the Board of Trustees University of Massachusetts. (10/2010 – 10/2014) 

Travis Foxx, M.D. - Premier Anesthesiology & Pain

Mark Reecer, M.D. - Fort Wayne Physical Medicine

Dr. Mark Reecer is board certified in Physical Medicine & Rehabilitation and Pain Management. He has over 20 years of work comp experience, and he routinely provides Independent Medical Examinations (IMEs) for the Indiana Workers’ Compensation Board. Dr. Reecer has lectured extensively and has authored multiple publications that promote his specialty and the use of treatment modalities to eliminate pain, improve function and avoid surgery.

Dmitry Buyanov, M.D. - IV Infusion Treatment Center

Dr. Buyanov is originally from Kiev, Ukraine. He received his training in Anesthesiology and his Interventional Pain Management Post-Doctoral at Penn State Medical Center, PA. Dr. Buyanov moved to San Antonio in 2003 at which time he was part of a multi-specialty group before he founded Premier Pain Consultants in 2004. His practice has over 5000 active patients in his practice. Dr. Buyanov treats his patients in a cost-effective manner although giving them the best care with interventional pain treatments/procedure to help each patient improve their quality of life. Dr. Buyanov strongly believes in an individualized and multidisciplinary approach to pain management, he believes in the Buddhist saying: “pain is inevitable but suffering is optional”. He works closely with the area internists, physical therapists, chiropractors, psychiatrists, neurologists, and spine surgeons to insure that each patient has the most optimal individualized treatment plan. Dr. Buyanov enjoys spending his spare time with his children.

Desmond Hussey, M.D. - NASA Neuroscience and Spine Associates. P.L

Dr. Hussey earned his undergraduate degree from Dartmouth College, and proceeded to earn his Medical Degree from The University of Miami School of Medicine. He then attended Northwestern University Internal Medicine Program, followed by a Neurology Residency Program at Emory University. Dr. Hussey continued his specialty training at John Hopkins University pain clinic. A member of The Spinal Injection Society and The American Academy of Neurology and Psychiatry.

Haley Burke, M.D. - Colorado Rehabilitation and Occupational Medicine

Dr. Burke is board-certified in both Interventional Pain Management and Neurology and has completed an accredited Pain Fellowship with the Department of Anesthesiology at MD Anderson Cancer Center, one of the nation’s most prestigious hospitals. Dr. Burke completed her residency in Neurology at the University of Colorado, where she received the department’s ‘Excellence in Teaching’ award during her year as Chief Resident. Her Doctor of Medicine degree was completed at the University of Texas Health Science Center, where she was elected to the ‘Gold Humanism Honor Society.’

Maxim Moradian, M.D. - Interventional Spine Care & Orthopedic Regenerative Experts

Dr. Moradian is triple-board certified in Physical Medicine and Rehabilitation (PM&R), Sports Medicine and Pain Management. Dr. Moradian’s clinical practice is devoted to the comprehensive care of spine, joint, muscle, tendon, ligament, and peripheral nerve disorders. He is proficient in performing advanced, minimally-invasive procedures under fluoroscopic and/or ultrasound guidance in the entire spine. Dr. Moradian performs electrodiagnostic testing (EMG/NCS) for the accurate diagnosis of muscle and/or nerve disorders. He has a special interest in regenerative medicine, sports concussions, neuromuscular ultrasound, medical education, and clinical research. His true passion is to treat his patients like his family and friends.

Wendi Lundquist, D.O. - Active Life Physical Medicine & Pain Center

Dr. Lundquist is the Medical Director and founder of Active Life Physical Medicine & Pain Center, Innovative Surgery Center, and Regena Spa. She is dual board certified in Physical Medicine and Rehabilitation along with Pain Management and a diplomat with the American Board of Pain Medicine. She completed her training at Loyola University in Chicago, Illinois in July of 2005. During her time there, she served as Chief Resident and was involved in several research projects. Prior to, she completed medical school at Midwestern University at the Arizona College of Osteopathic Medicine campus in Glendale, Arizona and internship at Doctors Hospital in Massillon, Ohio. She also has a Bachelor of Science in Biology and minor in Chemistry from the University of New Mexico in Albuquerque. She has a special interest in sports medicine, pain and spine. With 17 years experience, she has great enthusiasm towards regenerative medicine.

Michael Wolff, M.D. - Southwest Spine & Sports